This paper argues that tort reform would have precisely zero effect on the health insurance costs of Americans and would have very serious harmful effects on the lives of Americans who find it necessary to seek relief through a malpractice lawsuit.
1,935 words (approx. 7.7 pages), 6 sources, MLA, $ 61.95
Abstract This paper explains that tort reform, putting a cap on jury awards in malpractice suits, is exactly what the insurers want because, in addition to making a handsome profit on their medical malpractice lines as it stands, they would then have to pay out even less. The author points out that reducing consumer health insurance costs would be better served by a systematic effort to weed out bad doctors and prevent malpractice. The paper stresses that, even if there were a link between medical malpracticeinsurance costs and consumer health insurance costs, the culprit is the insurer itself because it is not allowed, by law, to raise rates in response to big payouts; insurers are allowed to raise rates when their projected investment income declines.
From the Paper "The suggestive portion of the NAIC findings is this: although malpractice insurance premiums make up such a small portion of health-care costs, medical malpractice as a line of insurance demonstrated the highest profit as a percentage of premiums (Stewart, 21+), making it very lucrative for the insurance companies. Further, losses paid by those insurers in 1991 came to only about 31 cents of every $100 of health care costs; remember, malpractice premiums accounted for 64 cents per $100 spent, leaving 33 cents for the company out of each $100. While the amount spent on malpractice insurance by the consumer, trough his or her medical expenditures, is negligible, there are a lot of people spending $100 frequently, massing up piles of 33 cents for the insurers."
Abstract This paper explains that the FDA and numerous other organizations report that prescriptions drugs cause an enormous number of preventable injuries and death resulting in "cap" laws, a rise in insurance costs, regulations on physicians and the death of innumerable innocent civilians. The author points out that, on the other hand, the non-partisan Congressional Budget Office finds that the costs associated with malpractice-buying insurance and paying out damage awards-amounts to less than two percent of America's skyrocketing healthcare expenses. The paper stresses that the problem of malpractice will not cease without the help of well trained doctors, honest and just politicians and insurance workers who value their customers.
From the Paper "In light of numerous large payouts associated with medical malpractice, President George W. Bush called for strict limits on medical malpractice suits, including a "cap of $250,000 on what victims and their families could recover for non-economic damages." He also inflicted an attack on lawyers fees, including a drop from thirty percent, to twenty on cases less than 600K. On cases exceeding 600K, he dropped twenty percent to fifteen percent. Now, let's look more in-depth. When taking on a malpractice suit, it immediately throws the victim and lawyer into a David and Goliath situation, and in light of Bush's bill, "David has lost his sling.""
Abstract This paper explains that the main reason why caps should exist on malpractice suit is the cost of malpracticeinsurance for doctors, which has forced many doctors to stop practicing medicine. The author points out that placing caps on malpractice awards might shield negligent doctors from being held accountable for their mistakes and might prevent patients from getting the monetary awards that match the economic and traumatic impact of the injuries they have incurred. The paper states that the solution to this issue is to place caps on malpractice awards; however, in extreme cases where negligence is apparent and the impact of such negligence is irrevocable, there must be exceptions to such caps.
Table of Contents
Introduction
Why Caps on Malpractice Awards
Why No Caps on Malpractice Awards
Discussion and Conclusion
From the Paper "The problems associated with malpractice awards came to the forefront in 2002 when a group of 60 specialists at the University Medical Center in Las Vegas refused to work because of the high cost of malpractice insurance. Their actions caused the hospitals emergency room to shut down. This gave Nevada and the nation a glimpse of the public health crisis that could ensue if caps are not placed on Malpractice Awards. In the case of Las Vegas, legislatures came together and placed a $350,000 cap on the amount of money that a patient could receive as a non economic award in a malpractice case. However, lawmakers did attach to exceptions to the bill including "one involving cases where there is "gross malpractice". The other where there is "clear and convincing" evidence that an award should exceed the $350,000 cap."
Abstract This paper takes a look at the global problem of medical malpractice and examines the issues and objectives concerning the development and enforcement of policies that would limit malpractice awards. The paper also recommends a set of objectives, options and actions that nurses and others can actively take to reduce their risk.
Table of Contents
Abstracts
Caps on Medical Malpractice Awards
Background
Issue Statement
Stakeholders
Policy Objectives
Policy Alternatives
Summary -- Recommended Policy
From the Paper "That malpractice is an industry cannot be denied. Attorneys, professional lobbying agents and agencies wine and dine politicians for their cause. The media follows every move. People are employed and significant money flows through the economy all due to the increase in malpractice suits and the amount of awards. There are a number of factions that comprise the growth of the malpractice industry and have significantly affected its development including social, economic, ethical, political and legal factors."
Abstract This paper explains that, whereas other industries afflicted by high premiums have shifted some of this burden to the customer by increasing the fees charged, this is generally not an option for the LTC industry because the great majority of patients in nursing homes have their costs paid by federal Medicare and Medicaid programs. The author points out that the high costs of the litigious climate are causing some states, such as Florida and Texas, to implement damage award caps. The paper stresses that the goal of preventing abuse and increasing the standards of care in long-term facilities is being thwarted by a system that pits lawyers against nursing homes.
From the Paper "The long-term care homes were the most profitable sector in the late 1980s, Fletcher writes, but are now the least profitable for the insurance industry. Losses are so extreme in the nursing home sector that many carriers are refusing to insure long-term facilities. Fletcher mentions two states, Florida and Texas that are hit particularly hard by insurance carrier losses. At the root of these skyrocketing premiums is the different legal climate that has awarded large settlements to plaintiffs in suits against LTC facilities."
Abstract This paper critically evaluates the statutes purposely passed to tackle Medicare and Medicaid insurance fraud. It evaluates the fundamentals, penalties, defenses, and safe harbor provisions for each and every statute, and concludes with a discussion of accessible legal safe harbor provisions. It discusses the wide-ranging federal statutes employed to impeach health care fraud, together with the False Claims, False Statements, and Mail and Wire Fraud Acts and explains the basics of the offenses, accessible defenses, and penalties valid under each statute. It also gives an indication of federal and state government agencies' pains to examine and take legal action against health care fraud.
Outline
Introduction
Statutes and Provisions Specifically Enacted to Address Medicare and Medicaid Fraud
Sale of Physician Practices, Practitioner Recruitment and Obstetrical MalpracticeInsurance Subsidies
Contracts for Space, Equipment, Personal Services and Employment
Advertisements and Promotions
Referral Services
Relationships Between Providers
Arrangements Between Providers and Health Plans
Relationships Between Providers and Suppliers
Prosecuting Health Care Fraud with General Federal Statutes
Conclusion
From the Paper "Individuals and organizations licensed by Department of Health and Human Services ("HHS") to accept imbursement under the Social Security Act may focus on Medicare and Medicaid fraud examinations (7). Persons, as well as organizations comprise nursing and rehabilitation centers, hospitals, Health Maintenance Organizations ("HMOs"), intermediate carriers for example private and public clinics, private insurance companies, durable medical equipment ("DME") providers, medical laboratories, physician practice groups, physicians, as well as other certified health care organizations (7)."
Abstract This paper critically evaluates the statutes purposely passed to tackle medicare and medicaid insurance fraud. It also examines the fundamentals, penalties, defenses, and safe harbor provisions for each and every statute, as well as concludes with a discussion of accessible legal safe harbor provisions. It discusses the wide-ranging federal statutes employed to impeach health care fraud, together with the False Claims, False Statements, and the Mail and Wire Fraud Acts, and explains the basics of the offenses, accessible defenses, and penalties valid under each statute. It also gives an indication of federal and state government agencies' pains to examine and take legal action against health care fraud.
Outline
Introduction
Statutes and Provisions Specifically Enacted to Address Medicare and Medicaid Fraud
Medicaid False Claims Statute
Penalties
Medicaid Anti-Kickback Statute
Sale of Physician Practices, Practitioner Recruitment and Obstetrical MalpracticeInsurance Subsidies
Contracts for Space, Equipment, Personal Services and Employment
Advertisements and Promotions
Referral Services
Relationships Between Providers
Arrangements Between Providers and Health Plans
Relationships Between Providers and Suppliers
Prosecuting Health Care Fraud With General Federal Statutes
False Claims Act
False Statements
Mail and Wire Fraud
Conclusion
From the Paper "An added safe harbor permits health plans with accords with CMS or a state health care program to give care for beneficiaries to augment coverage, decrease cost sharing amounts, or decrease premium amounts for enrollees under particular conditions. If the proposal is a competitive medical plan, health maintenance organization plan, prepaid health plan or any other plan with a contract with CMS or a state health care program, it has got to offer identical augmented coverage or reduced cost-sharing or payments to all Medicare or state health program enrollees unless CMS or the state endorses otherwise."
Abstract This is a nursing proposal suggesting what nurses can do to reduce risk while strongly advocating caps on malpractice awards. The current legislature on malpractice caps and the level of reduced care to patients is discussed. The patients' own inability to afford service, the affordability to practice by physicians and their need to increase patients' costs for services by ordering many more than medically necessary are all covered.
From the Paper "There is a vicious cycle taking place in the world of healthcare that involves patients, attorneys, physicians and healthcare professionals and facilities and insurance companies. Medical malpractice premium rates are forcing doctors and nurse practitioners to order medically unnecessary tests and pad bills or fold their practices. According to the Center for Legal Policy (as cited by Stableford, 2005) "unnecessary medical tests and constant referrals to specialists for second and third opinions costs an unnecessary $60 billion to $100 billion." Law suits continue to climb at an alarming rate with unconscionable awards that are not consistent with something that can be measured tangibly. Attorneys play on the sympathy of juries for neurological deformities of infants that could have naturally occurred genetically, not necessarily as a result of medical error, yet huge awards for punitive damages are awarded."
Abstract This paper presents an argument against capping medical malpractice awards. The paper discusses several reasons why capping awards should not be adopted as public policy, contending that capping limits injured patients' access to justice.
From the Paper "Capping medical-malpractice awards should not be adopted as public policy. It would be grossly inappropriate for several reasons. The much-discussed crisis in medical care that doctors and insurers attribute to malpractice litigation is misdirected and can be traced to other causes. The idea that malpractice awards are out of control and are increasing all the time is simply wrong and cannot be sustained by the facts which suggests that attempts to cap award amounts for punitive damages are being made in bad
This well-researched paper defines and details the advantages and disadvantages of two particular forms of insurance currently available in America: Re-insurance and treaty re-insurance.
Abstract The writer of this paper defines re-insurance as a basic method of underwriting insurance. Re-insurance falls mainly into two categories, the first being facultative re-insurance and treaty re-insurance, which are both handled by two separate companies. This paper details how both methods of insurance operate as well as how insured Americans are directly affected by these types of policies. This paper also discusses the individual risks involved with these forms of insurance as well as how downsizing and mergers have impacted the industry creating a shortage of qualified underwriters.
From the Paper "One area where Facultative Re-insurers are concentrating their efforts both in training and research is in the environmental area. Here the losses from just one storm, or earthquake or any other natural disaster is very costly for all concerned. While this effort continues and as clean up after the fact of a disaster we're seeing such improvements as "storm resistant" construction, rapid rescue techniques, and many other improvements all precipitated by the Facultative Re-insurance Industry. And there are constant changes being made in order to reduce costs and improve life in general for the insured public."
Tags:insurance, health, environment, coverage, american, re, munich, group, risk
Abstract This paper explains that the question of whether or not the presence of "utmost good faith" in marine insurance is equitable to either the insurer or the insured is a question of global debate, because, although it is codified in very old law, the advent of containerized freight has brought the issue to the forefront in several nations. The author points out that the investigation done by an Australian expert provides a clearer picture of these problems of the nation's position concerning the Marine Insurance Act and strongly suggests that the entire Marine Insurance Act be removed from the realm of the English Common Law and placed under the control of the United Nations. The paper relates that the inevitable question of precisely who does suffer the most--the insured through their ignorance, negligence or outright fraud or the insurers and the re-insures for failing to use protective technology and instead simply make the premiums higher to cover their actuarial losses; however, the real cost is borne by the citizenry of the world as another hidden tax.
Table of Contents
Thesis Statement
The History and Background of the Law
The World Wide Effects upon Nations
The World View and Conclusions
From the Paper "In his discourse concerning the Law of Marine Insurance - Utmost Good Faith at least in the sphere of Australian trade is having far too many losses therefore placing an unfair burden upon the insurers where perhaps the insured are quite possibly at fault. Again there are copious court cases cited in this section. It is this section of the law too that the Chancellor relates the United Nations efforts at curbing and enforcing the Utmost rules, but they have fallen miserably short of their goal."
An examination of State Children's Health Insurance Plan (S-CHIP); the legislation that allows states in the US to provide health insurance to more children from working class families.
Abstract This paper discusses the problems of the number of people in the United States who cannot afford health insurance. It specifically looks at the effects of under-insurance or lack of insurance for children. The paper then discusses and analyzes S-CHIP (State Children's Health Insurance Plan), the legislation that allows states in the US to provide health insurance to more children from working class families. The paper contains tables.
Table of Contents:
Introduction
Methodology
Results
Discussion
Conclusion
From the Paper "The S-CHIP program has been very successful in helping solve one aspect of the healthcare problem, by providing health insurance to financially disadvantaged children who live above the poverty line. In states with vigorous S-CHIP programs, a huge number of people take advantage of S-CHIP. Other states do not pursue S-CHIP with the same vigor, and have reduced S-CHIP participation. However, every state but Tennessee shows significant numbers of children being assisted by the S-CHIP program. Moreover, state governors and legislators are very supportive of the S-CHIP program, because they have seen the real differences it has made in healthcare access for the financially disadvantaged. In fact, many states have sought to expand their state's S-CHIP eligibility requirements, because of the public response to S-CHIP availability. It is clear that S-CHIP has met its legislative goals and should be continued."
Abstract This paper discusses the health care crisis in the United States. The paper notes that health care costs have been rising beyond the rate of inflation for quite some time, and many Americans are starting to realize the severity of the issue. The paper examines the causes of the problem and discusses solutions that will help to minimize it. To analyze the situation, the paper looks at economic literature and then applies this economic framework to the current policies that affect the health care market. The paper continues by using the same framework and analyzes alternative policies and institutions and recommends a set of policies to best address the issue. The paper is illustrated with graphs and tables.
Outline:
Introduction
Literature Review
Class Probability
Insurable and Uninsurable Risks
Sub-Classification of Risks
Moral Hazard of Insurance Analysis of Current Policies and Institutions
The AMA
Moral Hazard of Health Insurance and the Problem of Sub-classification
Incentives to Use Health Insurance Public Health Insurance Analysis of Alternative Policies and Institutions
Limiting the Market Power of the AMA
High Deductible Health Insurance Health Savings Accounts
Conclusion
From the Paper "The purpose of insurance is to pool a particular risk among a group of individuals so as to reduce the amount of risk facing any one individual. Risk can be defined as the uncertainty about a particular negative outcome occurring in the future. If the perceived risk is financial in nature, then an individual may choose to pay a fraction of the cost into an insurance pool, thereby eliminating the possibility of incurring the cost in its totality."
Tags: income-elastic, economic, framework, a, risk, based, insurance, pool
Abstract This paper examines the issue of arbitration and insurance claims. It begins by explaining a series of basic insurance terminology and then presents a history of the practice of insurance arbitration. The writer then explains the process of arbitration and insurance claims and how the process has changed over the years.
From the Paper "Almost thirty years ago, the Committee on Insurance Arbitration recognized the insurance industry's need for a Property Arbitration Forum. Today, its' successor committee is the largest system of its kind in the world. There was clearly a need to create a legal entity to administer the arbitration programs, and this concern led to the creation of a not-for-profit corporation that replaced the Committee on Insurance Arbitration. The Committee on Insurance Arbitration incorporated in 1981, under the corporate name of Insurance Arbitration Forums. Insurance Arbitration Forums remained the corporate name until 1986, when the Board of Directors eliminated the word "Insurance" from the name. This change reflected the expansion of Arbitration Forums' programs to include arbitration situations outside the insurance arena, although these additional mediation and arbitration services continued to fulfill the needs of the insurance industry. Because Arbitration Forums are intended to provide an objective and neutral administrative service, Arbitration Forums are considered to be respected and efficient providers of arbitration services. Arbitration is a means of settling controversies without resorting to litigation. Agreements to arbitrate are generally put into writing, and signatories are contractually obligated to arbitrate."
Abstract T|his paper explains the way to detect automobile insurance fraud and points out methods of investigating. The author relates sentencing for convicted fraud offenders. The paper reports the increasingly costly problem of auto insurance fraud.
From the Paper "Americans pay an exorbitant amount of money each year to insure their vehicles for which they have also paid handsomely. ... Americans paid an estimated ... billion for auto insurance. Why are costs so high? One factor that plays into the soaring rates of automobile insurance is the dramatic increase in car insurance fraud. Consider this scenario. A typical driver is driving through town innocently minding their own business on the way to ..."
Tags: automobile insurance fraud, car insurance, fraud, schemes, fraudulent, identity theft, claimants, insured, insurance company
